Dr. Hall,
I recently broke my front tooth off, right below the gumline. I am looking for the cheapest, easiest, fastest way to fix this. I am 100% against implants.
– Harley from Nebraska

Harley,
Are you really asking me this? I don’t think you really mean the question the way it came out.

For the cheapest, easiest, fastest way to fix your broken front tooth, go to Walmart, buy a tube of Superglue, and glue your tooth back in. Cheap, easy, fast.

Problem is, the repair will only last for a couple of days. But long-lasting wasn’t on your list of requirements.

Another solution, not as cheap but also easy and fast and, as a bonus, long-lasting, would be to have a dentist bond a glob of composite onto the broken part of the tooth, making a little mound. That would last a long time. It wouldn’t look very good, though, but looking good wasn’t on your list.

Let’s re-order your priorities and make it first, something that will look good, and second, something that will hold up long-term. To accomplish that, there are two options. And neither one is cheap, easy, or quick.

It could be possible to repair the tooth by placing a crown on the remaining root. But that would only work if there isn’t a lot of stress on this tooth. If you have a deep overbite or even just a strong bite, it would be hard to get the crown to stay on. But if you have a gentle bite, it could work. You would need to have a root canal treatment on the remnant of your tooth, then have a good, strong post that’s not completely rigid. Either a carbon fiber post or a fiberglass post would work. The stress on a front tooth is mostly lateral. If you have a rigid metal post going down into the root and then put stress on the crown of the tooth, that stress will transfer to the root through the post and tend to cause a root fracture. If the post has a little flexibility to it, however, it will not transfer stress to the root and thus not tend to fracture the root.

And better yet, I would place two posts side by side, to help resist rotational forces that would tend to weaken the bond to the tooth over time. All posts are perfectly round, so any twisting force on them will tend to dislodge them.

However, if there is any significant stress on this tooth, the only solution that will hold up over a long time would be replacing the tooth with a dental implant. This could cost twice as much as a root canal, posts, and crown, and would take substantially longer because of the healing time required. But it would look good and last much longer. Doing the crown first could have you ending up with the dental implant eventually because the crown would fail.

Bottom line—sometimes the cheapest dental solution is the most expensive, the quickest solution takes the longest, and the easiest solution is the most complicated. It’s generally best to just fix it right in the first place and then be done.

– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.